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1.
Rev. neurol. (Ed. impr.) ; 69(1): 11-17, 1 jul., 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184006

RESUMO

Introducción. El cuidado de los pacientes con enfermedad de Alzheimer incrementa la sobrecarga y la depresión del cuidador principal, aunque la relación entre ambas no está claramente definida. Objetivos. Explorar los factores asociados a la sintomatología depresiva y la sobrecarga en el cuidador principal y aplicar un modelo de ecuaciones estructurales para identificar la relación entre ellas. Sujetos y métodos. La muestra estuvo formada por 127 cuidadores familiares de personas con enfermedad de Alzheimer, con un seguimiento de 24 meses. Se realizaron análisis de regresión multivariante para identificar las características de pacientes y cuidadores asociadas a la sobrecarga y la depresión del cuidador principal, y se diseñó un modelo de ecuaciones estructurales para analizar la relación entre las variables. Resultados. En el modelo de ecuaciones estructurales, la sobrecarga tuvo un efecto directo sobre la depresión, tanto en la evaluación basal como a los 24 meses. Las variables asociadas a la sobrecarga fueron: la escolaridad y la menor salud mental del cuidador principal, y las alteraciones conductuales y la dependencia funcional del paciente. El menor nivel cognitivo del paciente y la menor salud mental del cuidador principal estuvieron asociados a la depresión. La correlación entre sobrecarga y depresión aumentó desde la evaluación basal hasta los dos años (r = 0,47 frente a r = 0,613). Conclusiones. El deterioro del paciente y la sobrecarga son factores de riesgo para la depresión en el cuidador principal. Serían necesarias intervenciones para reducir la carga y poder prevenir la depresión relacionada


Introduction. The care of patients with Alzheimer’s disease increases the burden and depression of the main caregiver, although the relationship between the two is not clearly defined. Aims. To explore the factors associated with depressive symptomatology and burden in the main caregiver and to apply a model of structural equations to identify the relationship between them. Subjects and methods. The sample consisted of 127 family caregivers of people with Alzheimer’s disease, with a follow-up of 24 months. Multivariate regression analyses were performed to identify the characteristics of patients and caregivers associated with burden and depression of the main caregiver, and a model of structural equations was designed to analyse the relationship between the variables. Results. In the model of structural equations, the burden had a direct effect on depression, both in the baseline assessment and at 24 months. The variables associated with burden were: schooling and the lower mental health of the main caregiver; and the behavioral alterations and the functional dependency of the patient. The lower cognitive level of the patient and the lower mental health of the main caregiver were associated with depression. The correlation between burden and depression increased from baseline to two years (r = 0.470 vs. r = 0.613). Conclusions. The deterioration of the patient and caregiver burden are risk factors for depression in the main caregiver. Interventions would be necessary to reduce the burden and prevent related depression


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Depressão/psicologia , Cuidadores/psicologia , Doença de Alzheimer/enfermagem , Modelos Teóricos , Fatores Socioeconômicos , Fatores de Risco
2.
J Am Assoc Nurse Pract ; 31(5): 282-284, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083007

RESUMO

Neurodegenerative diseases are more common in older individuals and are progressively debilitating. Due to the aging of the American population, the burden of neurodegenerative diseases on the health care infrastructure will likely significantly increase in the near future. Genetic science has advanced our understanding of the pathology driving these diseases thereby informing new, individualized care paradigms. Although translation into clinical practice is slow, there are a few examples of instances where precision medicine is making a difference in the care of patients with neurodegenerative diseases that may be driven by genetic background. This article provides a brief overview of the current knowledge of genetic influences on two common neurodegenerative diseases, Alzheimer Disease and Parkinson Disease, as well as ways this knowledge is being tested for a precision medicine approach to care.


Assuntos
Doenças Neurodegenerativas/genética , Doença de Alzheimer/genética , Doença de Alzheimer/enfermagem , Humanos , Programas de Rastreamento/métodos , Doenças Neurodegenerativas/enfermagem , Doença de Parkinson/genética , Doença de Parkinson/enfermagem , Medicina de Precisão/métodos , Medicina de Precisão/tendências , Fatores de Risco
3.
Rev Infirm ; 68(247): 32-34, 2019 Jan.
Artigo em Francês | MEDLINE | ID: mdl-30910116

RESUMO

The provision of physical, mental and social care to people with Alzheimer's disease is a major public health challenge. With the awareness of progressive neurological disorders and their consequences, the personal and psychological dimension of each patient must lie at the heart of the care provided throughout the disease's progression. This personalisation can have positive clinical effects while helping to preserve as much as possible the dignity of the people concerned.


Assuntos
Doença de Alzheimer , Doença de Alzheimer/enfermagem , Conscientização , Progressão da Doença , Empatia , Humanos , Estresse Psicológico
4.
Metas enferm ; 22(2): 5-11, mar. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183514

RESUMO

Objetivo: el objetivo de este trabajo fue conocer las vivencias y sentimientos de las personas cuidadoras principales de familiares con enfermedad de Alzheimer. Método: se realizó un estudio cualitativo con enfoque fenomenológico. Las personas participantes fueron captadas a través de la Asociación de Familiares de Enfermos de Alzheimer de Ourense. Los datos se obtuvieron a través de entrevistas semiestructuradas efectuadas por dos entrevistadoras, enfermeras, hasta que se llegó a la saturación del discurso. Resultados: se identificaron 10 categorías: diagnóstico y cambio de identidad; cuidados; organización del núcleo familiar; impacto psicológico en las personas cuidadoras; autocuidado del cuidador; recursos; miedo al futuro; experiencias positivas; relación con el profesional de Enfermería; institucionalización. Conclusiones: las personas cuidadoras refirieron la importancia de su autocuidado, intentando encontrar tiempo para ellas mismas y poder desconectar. Su mayor inquietud es la evolución de la enfermedad y el "irse apagando" del familiar, lo que ocasiona sentimientos de tristeza e impotencia. A raíz de esta experiencia de cuidar, descubrieron aptitudes y sentimientos que eran desconocidos, desarrollando su capacidad para hacer frente a las adversidades y aprender de ellas


Objective: the objective of this study was to understand the experiences and feelings of the primary caregiver persons for relatives with Alzheimer's disease. Method: a qualitative study was conducted, with phenomenological approach. Participants were recruited through the Association of Relatives of Alzheimer's Patients from Orense. Data were collected through semistructured interviews conducted by two nurse interviewers, until reaching speech saturation. Results: ten (10) categories were identified: diagnosis and change of identity; care; organization of the family unit; psychological impact on caregivers; self-care of the caregiver; resources; fear of the future; positive experiences; relationship with the Nursing professional; institutionalization. Conclusions: caregivers reported the importance of self-care, trying to find time for themselves and being able to disengage. Their higher concern was disease evolution, and the "fading out" of their relative, which causes feelings of sadness and impotence. Through this caregiving experience, they discovered attitudes and feelings that were unknown to them, thus developing their ability to face adversities and learn from them


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Cuidadores/psicologia , Doença de Alzheimer/enfermagem , Doença de Alzheimer/psicologia , Papel do Profissional de Enfermagem , Análise Qualitativa , Autocuidado/psicologia , Pesquisa Qualitativa , Relações Familiares/psicologia , Diagnóstico Tardio , Relações Profissional-Família , Entrevistas como Assunto
5.
Int J Med Inform ; 123: 29-36, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30654901

RESUMO

BACKGROUND: The healthcare system faces a major challenge in caring for an increasingly ageing population as this task requires more resources than are currently available. Adopting monitoring technologies could enable more efficient care practices and support ageing in place. OBJECTIVES: To investigate how the use of an in-home motion monitoring system can be integrated into home care nurses' workflows and to uncover the factors behind system adoption. DESIGN: A single case study adopting a qualitative approach. SETTING: A home care unit serving older adults living in independent living residences within an apartment complex. METHOD: Multiple data collection methods were used including individual and group interviews, a questionnaire with open-ended questions, evaluation probes, and system log data. The qualitative material was analysed using a stepwise-deductive inductive approach. RESULTS: A central factor behind system adoption was the perceived usefulness of gaining information about older adults' night-time activities. In particular, monitoring older adults suffering from memory disorders was considered advantageous. The information that the system provided supported nurses in health assessments and assisted in adjusting care decisions. Previous negative experiences with similar technologies initially influenced the time for adoption. Further, although nurses were closely involved in the system design process, they took some time to get acquainted with the system and to integrate its use into daily practice. System reliability and accuracy issues influenced nurses' trust in the sensory data. CONCLUSION: The findings suggests that in a home care setting, focusing on motion pattern monitoring for older adults with memory disorders can provide significant benefits and therefore also facilitate system adoption among nurses. Involving nurses in the design of the technology and providing opportunities to trial the system in real practice also appear to be important in achieving system adoption.


Assuntos
Atividades Cotidianas , Doença de Alzheimer/enfermagem , Tomada de Decisões , Serviços de Saúde para Idosos/normas , Monitorização Ambulatorial/instrumentação , Enfermeiras e Enfermeiros/psicologia , Fluxo de Trabalho , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Percepção , Inquéritos e Questionários
6.
Psychol Health Med ; 24(1): 27-34, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30141703

RESUMO

Aim of this study is to examine caregiver burden and family functioning in different neurological conditions. Forty-two primary caregivers of patients with Amyotrophic Lateral Sclerosis (ALS), Alzheimer's Disease and other dementia (AD), Parkinson's Disease (PD), Acquired Brain Injuries (ABI) and Multiple Sclerosis (MS) were administered scales for the evaluation of caregiver burden (CBI) and family functioning (FACES IV). Caregiver burden was overall high, with caregivers of patients with ALS and ABI having exceeded the CBI cut-off score for possible burn-out. The average scores of caregivers of patients with AD or other dementia and PD were close to the cut-off score, whereas those of caregivers of patients with MS were significantly lower than the others. Family cohesion, family satisfaction and the quality of family communication were associated with reduced levels of caregiver burden, whereas disengagement was associated with a higher burden. The data from the present study confirm that caregiver burden is a relevant issue in the context of neurological diseases, especially for those causing higher degrees of impairment. Significant correlations with family functioning emerged as well, highlighting the importance of studying and treating caregiver burden within the context of family relations.


Assuntos
Esclerose Amiotrófica Lateral/enfermagem , Lesões Encefálicas/enfermagem , Cuidadores , Efeitos Psicossociais da Doença , Demência/enfermagem , Família , Esclerose Múltipla/enfermagem , Doença de Parkinson/enfermagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Geriatr Nurs ; 40(3): 257-263, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30503603

RESUMO

Despite the rising prevalence of Alzheimer's disease (AD), there is limited systematic evidence about disease specific decisions. The aim of this qualitative descriptive study was to identify decisions across the AD trajectory using focus groups of past and present caregivers. Qualitative content analysis revealed three main categories with corresponding categories and sub-categories. Main Category One-Decisions pertaining to self-yielded two categories: decision pertaining to the offering of self and care for the caregiver. Main Category Two-Decisions pertaining to the patient-yielded three categories: decisions about care and treatment, living arrangements, and protecting the patient from harm. Main Category Three-Communication and relationships in decisions-yielded two categories: navigation and negotiations. The results of this study will inform healthcare providers and caregivers as they work together to anticipate, prepare, and plan for care management decisions over the AD trajectory.


Assuntos
Doença de Alzheimer/enfermagem , Cuidadores/psicologia , Tomada de Decisões , Incerteza , Feminino , Grupos Focais , Humanos , Masculino , Pesquisa Qualitativa , Qualidade de Vida
8.
Geriatr Nurs ; 40(2): 181-184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30366611

RESUMO

This study described experiences of caregivers of persons with Alzheimer's disease and other dementias (ADRD) and caregivers of persons with other chronic conditions on self-reported health, type of assistance they provide, perceptions of how caregiving interferes with their lives, and perceived level of support. A secondary analysis was conducted of the 2013 Porter Novelli SummerStyles survey data. Of the 4033 respondents, 650 adults self-identified as caregivers with 11.6% caring for people with ADRD. Over half of all caregivers reported that caregiving interfered with their lives to some extent. The greater the perceived support caregivers reported, the less they thought that caregiving interfered with their lives (p < .001). No significant differences were found between ADRD and non-ADRD caregivers regarding general health, types of assistance they provided, and perceived level of support. These findings have the potential to inform future research and practice in the development of supportive services for caregivers.


Assuntos
Doença de Alzheimer/enfermagem , Cuidadores/psicologia , Doença Crônica/enfermagem , Autoavaliação Diagnóstica , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Social , Inquéritos e Questionários
9.
BMC Med Res Methodol ; 18(1): 154, 2018 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-30497417

RESUMO

BACKGROUND: Systematic reviews (SRs) and meta-analyses (MAs) are distillation of current best available evidence, but are potentially prone to bias. The bias of SRs and MAs comes from sampling bias, selection bias and within study bias. So, their reporting quality is especially important as it may directly influence their utility for clinicians, nurses, patients and policy makers. The SRs and MAs on nursing interventions in patients with Alzheimer's disease (AD) have been increasingly published over the past decade, but the reporting quality of article has not been evaluated after the introduction of Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) Statement. METHODS: According to the inclusion and exclusion criteria, we searched the databases including PubMed, EMBASE and The Cochrane Library from inception through October 16th 2018. Two reviewers independently selected articles and extracted data. The PRISMA checklist was adopted to evaluate reporting quality. Comparisons were made between studies published before (2001-2009) and after (2011-2018) its introduction. RESULTS: A total of 77 eligible articles, 18 (23.4%) were published before the PRISMA Statement and 59 (76.6%) were published afterwards. There was higher score after publication of the PRISMA Statement than before (20.83 ± 3.78 vs 17.11 ± 4.56, P <  0.05). There was an improvement in the following items after the PRISMA statement was released (P <  0.05): title (item 1, 50.0% vs 74.6%, OR = 3.10, 95CI%: 1.00-9.61), search (item8, 27.8% vs 57.6%,OR = 3.25, 95CI%: 1.14-9.28), study selection (item 9, 44.4% vs 81.4%,OR = 6.28, 95CI%: 1.93-20.37), Data collection process (item 10, 50.0% vs 76.3%,OR = 3.45, 95CI%:1.10-10.84), risk of bias in individual studies (item 12, 50.0% vs 83.1%, OR = 5.78, 95CI%:1.71-19.52), risk of bias across studies (item15, 5.6% vs 28.8%,OR = 3.60, 95CI%:1.04-12.43), study characteristics (item 18, 77.8% vs 98.3%, OR = 28.13, 95CI%:3.35-236.19), risk of bias with studies (item 19, 50.0% vs 83.1%, OR = 5.78, 95CI%:1.71-19.52), results in individual studies (item 20, 72.2% vs 94.9%, OR = 11.09, 95CI%:1.99-61.82), conclusions (item 26, 77.8% vs 98.3%, OR = 28.13, 95CI%:3.35-236.19). After controlling for the confounding factors, there were higher PRISMA score for systematic reviews including meta-analyses, protocol or registration, can't answer of RCT, journal source of SCI (Science Citation Index), manuscript length > 13 page and funding support. CONCLUSION: Since the publication of the PRISMA Statement, there has been an improvement in the quality of reporting of SRs and MAs on nursing interventions in patients with AD. More endorsement by journals of the report guideline for SRs/MAs may improve articles reporting quality, and the dissemination of reliable evidence to nurses. We recommend authors, readers, reviewers, and editors to become more acquainted with and to more strictly adhere to the PRISMA checklist.


Assuntos
Doença de Alzheimer/enfermagem , Metanálise como Assunto , Publicações Periódicas como Assunto/normas , Relatório de Pesquisa/normas , Terminologia Padronizada em Enfermagem , Revisão Sistemática como Assunto , Viés , Lista de Checagem/normas , Lista de Checagem/estatística & dados numéricos , Humanos , Publicações Periódicas como Assunto/estatística & dados numéricos
10.
J Soc Work End Life Palliat Care ; 14(4): 274-290, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30457443

RESUMO

The death of an older adult with dementia often has an uncertain dying trajectory and has been referred to as "the long goodbye." Researchers have found both positive and negative outcomes of pre-death grief for caregivers of individuals with chronic illnesses. This qualitative study explored the end-of-life experiences for 36 bereaved family caregivers of older adults with dementia; focusing on understanding their experiences with pre-death grief. These caregivers shared experiences with the phenomenon of "welcoming death" and findings highlighted the primary reasons they anticipated, accepted, or wished for the death of their family member with dementia. With the overarching goal of improving bereavement outcomes and reducing feeling of guilt, inclusion of pre-death grief support services throughout the caregiving process are recommended.


Assuntos
Doença de Alzheimer/enfermagem , Cuidadores/psicologia , Família/psicologia , Pesar , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Morte , Demência/enfermagem , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Casas de Saúde , Pesquisa Qualitativa
11.
Rev. pesqui. cuid. fundam. (Online) ; 10(4): 941-944, out.-dez. 2018.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-915565

RESUMO

Objetivo: Verificar o conhecimento produzido pelos pesquisadores a respeito da saúde do idoso com doença de Alzheimer (DA). Métodos: Revisão integrativa da literatura com levantamento bibliográfico realizado nas bases de dados Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (MEDLINE) e nos bancos de dados do Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes). Resultados: Observou-se a incipiência de artigos científicos publicados sobre a DA com enfoque na saúde da pessoa idosa. Conclusão: Verificou-se a necessidade de pesquisas para investigar a saúde do idoso em virtude da DA que possibilitem aporte teórico na elaboração de políticas públicas de saúde mais abrangentes para os cuidados aos idosos


Objective: The study's purpose has been to verify the knowledge produced by the researchers with regards to the health of elderly people bearing Alzheimer's disease. Methods: It is an integrative review of the literature where the bibliographical survey was carried out in the following databases: Biblioteca Virtual em Saúde, MEDLINE and Portal de Periódicos Capes. Results: It was observed an incipient number of published scientific articles concerning the Alzheimer's disease with a focus on the elderly' health. Conclusion: It was verified the need for carrying out researches aiming to address the lack of scientific resource in order to investigate the elderly's health facing the Alzheimer's disease, and also to provide a theoretical contribution regarding the elaboration of comprehensive public health policies for the care of elderly people


Meta: Compruebe el conocimiento producido por los investigadores acerca de la salud de las personas mayores con la enfermedad de Alzheimer. Métodos: Integradora de la literatura con la literatura que tuvo lugar en la Biblioteca Virtual en Salud, MEDLINE y bases de datos del Portal Capes Periódico. Resultados: Había una escasez de artículos científicos publicados sobre la Enfermedad de Alzheimer centrándose en la salud de las personas de edad. Conclusión: Hay una necesidad de investigación para investigar la salud de las personas mayores en la cara de la enfermedad de Alzheimer permitiendo contribución teórica en el desarrollo de políticas más integrales de salud pública para el cuidado de los ancianos


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/enfermagem , Doença de Alzheimer/terapia , Saúde do Idoso , Envelhecimento , Brasil
12.
Curr Alzheimer Res ; 15(13): 1213-1219, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30251603

RESUMO

BACKGROUND: At present, the number of older people is growing, especially in the developed countries where the living conditions enable a longer life expectancy. However, the higher age may result in the aging diseases such as dementia out which Alzheimer's disease (AD) is the most frequent. Nevertheless, to maintain them both physically and mentally active, more assistance is required. OBJECTIVE: The purpose of this study is to discuss the efficacy of the use of modern information technologies, especially computer-based training programs, on people with Alzheimer's disease (AD). RESULTS: Although the results from the selected studies do not indicate that the computer-based training programs are effective in the delay of cognitive decline is concerned, they suggest that these computerbased training programs are at least appropriate for the improvement of their behavioural symptoms and progression of the disease. CONCLUSION: Generally, these technological devices may contribute to the reduction of patients´ and their caregivers´ costs and certain flexibility, and thus the improvement of the quality of their life.


Assuntos
Doença de Alzheimer/enfermagem , Educação/métodos , Terapia Assistida por Computador/métodos , Doença de Alzheimer/psicologia , Cuidadores/psicologia , Progressão da Doença , Humanos
13.
J Christ Nurs ; 35(4): 218-227, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30198992

RESUMO

The growing elderly population is creating record numbers of individuals with Alzheimer's disease (AD) and other dementias. Nursing has an unprecedented opportunity to rethink how we care for adults with dementia, reduce the burden of caregivers, and preserve the personhood of patients. This article reviews AD and dementia pathophysiology, history, screening, stigma, treatments and interventions, and caregiver support. A nurse's journey with her mother with AD imparts the meaning of patient dignity.


Assuntos
Doença de Alzheimer/enfermagem , Cristianismo , Papel do Profissional de Enfermagem/psicologia , Relações Enfermeiro-Paciente , Religião e Psicologia , Espiritualidade , Atitude Frente a Morte , Humanos , Pesquisa em Educação de Enfermagem , Religião e Medicina
14.
Dement Geriatr Cogn Disord ; 46(1-2): 100-108, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30145591

RESUMO

BACKGROUND: We examine the utility of individualizing activities for persons with dementia (PwD) on the basis of congruence with preferences. Previous studies demonstrated only limited evidence of individualization of activity content to improve response, tended not to consider group activities, or were inconclusive. METHODS: Participants were 90 PwD residing in a nursing home or attending a day center. After family and staff caregivers rated preferences for music, exercise, reading, brain games, and baking, group activities were conducted, and the impact on mood and engagement was monitored. We tested whether participants showed more engagement and better mood when group activities were related to topics they liked, in comparison to topics they did not like (within-person analysis), and whether persons who liked certain topics showed better outcomes in comparison to persons who did not like those topics (between-person analyses). RESULTS: Within-person analysis found a relationship between the report of liking the topic and engagement and mood during the group activity, confirming the benefit of individualizing activities to persons' preferences. Between-person analyses were statistically significant only when based on staff preference ratings. CONCLUSION: Despite the fact that each topic represents a wide range of possible activities, individualizing group activities based on participants' preferences can optimize the impact.


Assuntos
Doença de Alzheimer/enfermagem , Doença de Alzheimer/psicologia , Cuidadores/psicologia , Processos Grupais , Atividades de Lazer , Preferência do Paciente , Centros-Dia de Assistência à Saúde para Adultos , Afeto , Idoso , Idoso de 80 Anos ou mais , Atenção , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Individualidade , Masculino , Pessoa de Meia-Idade , Casas de Saúde
15.
Inquiry ; 55: 46958018787992, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30047810

RESUMO

Specialty care units (SCUs) in nursing homes (NHs) grew in popularity during the 1990s to attract residents while national policies and treatment paradigms changed. Alzheimer disease has consistently been the dominant form of SCU. This study explored the extent to which chain affiliation, which is common among NHs, affected SCU bed designation. Using data from the Online Survey Certification and Reporting (OSCAR) from 1996 through 2010 with 207 431 NH-year observations, we described trends and compared chain-affiliated NHs with independent NHs. Designation of beds for Alzheimer disease SCUs grew from 1996 to 2003 and then declined. At the peak, 19.6% of all NHs had at least one Alzheimer disease SCU bed. In general, chain affiliation promoted Alzheimer disease SCU bed designation across time, chain size, and NH profit status. During the period of largest growth from 1996 to 2003, the likelihood of designation of Alzheimer disease SCU beds was 1.55 percentage points higher among for-profit NHs affiliated with large chains than independent for-profit NHs ( P < .001) and remained 1.28 percentage points higher from 2004 to 2010. However, chain-affiliated NHs generally had a lower percentage of residents with dementia than independent NHs. For example, although for-profit NHs affiliated with large chains had more Alzheimer disease SCU beds, they had nearly 3% fewer residents with dementia than independent NHs ( P < .001). We conclude that organizational decisions to designate beds for Alzheimer disease SCUs may be related to marketing strategies to attract residents since adoption of Alzheimer disease SCUs has fluctuated over time, but did not appear driven by demand.


Assuntos
Doença de Alzheimer/enfermagem , Medicina , Casas de Saúde , Propriedade , Idoso , Idoso de 80 Anos ou mais , Humanos , Estudos Longitudinais , Modelos Estatísticos , Casas de Saúde/economia , Casas de Saúde/organização & administração , Inquéritos e Questionários
16.
J Gerontol Nurs ; 44(8): 19-26, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30059136

RESUMO

Nighttime agitation, sleep disturbances, and urinary incontinence (UI) occur frequently in individuals with dementia and can add additional burden to family caregivers, although the co-occurrence of these symptoms is not well understood. The purpose of the current study was to determine the feasibility and acceptability of using passive body sensors in community-dwelling individuals with Alzheimer's disease (AD) by family caregivers and the correlates among these distressing symptoms. A single-group, descriptive design with convenience sampling of participants with AD and their family caregivers was undertaken to address the study aims. Results showed that using body sensors was feasible and acceptable and that patterns of nocturnal agitation, sleep, and UI could be determined and were correlated in study participants. Using data from body sensors may be useful to develop and implement targeted, individualized interventions to lessen these distressing symptoms and decrease caregiver burden. Further study in this field is warranted. [Journal of Gerontological Nursing, 44(8), 19-26.].


Assuntos
Doença de Alzheimer/enfermagem , Monitoramento Ambiental/instrumentação , Enfermagem Geriátrica/métodos , Monitorização Ambulatorial/instrumentação , Agitação Psicomotora/diagnóstico , Transtornos do Sono-Vigília/diagnóstico , Incontinência Urinária/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Curr Alzheimer Res ; 15(11): 1027-1031, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29962343

RESUMO

BACKGROUND: Caregivers of persons with Alzheimer's Disease (AD) often experience feelings of lack of support and information from specialists when operating in real scenarios, inclusive of old-age psychiatric wards, care homes, community, and patient's home. OBJECTIVE: AD caregivers can provide narrative about what issues need to be addressed in Ecological Momentary Assessment (EMA) to capture real-time and real-scenario needs in AD caregiving, and Ecological Momentary Interventions (EMI) as online e-learning to assist in areas of concerns. METHOD: Twelve focus group discussions took place with AD caregivers for a total of 62 people interviewed. Once major themes in surveys and learning were identified by using discourse analysis, AD caregivers expressed the likelihood that these themes (where 0 meant "nil" and 1 meant "completely") would address their focal needs in caregiving and topics in learning. Z scores for proportions and Cohen's d effect size were calculated for each item reporting the averaged scores. RESULTS: AD caregivers indicated that the major areas of concern that could benefit from an EMA/EMI online platform were: support (d=3.08), collaboration (d=1.85), medication review (d=1.21), dealing with grief and mourning, and time (d=0.97). Moreover, they identified personal resources available to provide help to colleagues: support (d=1.34), information (d=0.97), collaboration (d=2.06), hospital admission (d=3.08), and hospital discharge (d=5.50). CONCLUSION: Focus groups and narratives can be the initial stage in creating a dedicated AD app supporting EMA/EMI in AD care.


Assuntos
Doença de Alzheimer/terapia , Cuidadores/psicologia , Avaliação Momentânea Ecológica , Doença de Alzheimer/enfermagem , Feminino , Humanos , Masculino , Autogestão , Inquéritos e Questionários
18.
Stud Health Technol Inform ; 251: 309-312, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29968665

RESUMO

Support of autonomy, at the onset and while Alzheimer's Disease progresses, is of utmost importance for both older adults and their caregivers. AD-Autonomy project aims at co-creating an innovative training platform with and for elderly people and their caregivers. Main aim of the project is to increase the competencies of older adults and their caregivers to cope with the disease effects, by leveraging existing ICT tools and applications, while transferring their applicability in real life contexts and activities. Initial anecdotal feedback is collected through a co-creation session, where all above themes were discussed and analyzed between seniors, family caregivers and professionals.


Assuntos
Doença de Alzheimer/reabilitação , Autonomia Pessoal , Equipamentos de Autoajuda , Educação Vocacional , Idoso , Doença de Alzheimer/enfermagem , Cuidadores , Humanos
19.
Acta Neuropathol Commun ; 6(1): 44, 2018 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-29855361

RESUMO

Several studies suggest that women have a higher risk to develop Alzheimer's disease (AD) than men. In particular, the number of pregnancies was shown to be a risk factor for AD and women with several pregnancies on average had an earlier onset of the disease, thus making childbearing a risk factor. However, the impact of being pregnant on Aß plaque pathology and adult neurogenesis still remains elusive. Postmortem analysis revealed that pregnant 5xFAD transgenic mice had significantly more Aß plaques in the hippocampus from G10 onwards and that the number of Ki67 and DCX positive cells dramatically decreased during the postpartum period. Furthermore, 5 months old 5xFAD transgenic mice that also nursed their offsprings for 4 weeks had a similar Aß plaque load than merely pregnant mice, indicating that pregnancy alone is sufficient to elevate Aß plaque levels. Interestingly, housing in an enriched environment reduced the Aß plaque load and vivified neurogenesis. Our results suggest that pregnancy alters Aß plaque deposition in 5xFAD transgenic mice and diminishes the generation of newborn neurons. We conclude that pregnancy alone is sufficient to induce this phenotype that can be reversed upon environmental enrichment.


Assuntos
Doença de Alzheimer/enfermagem , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/metabolismo , Meio Ambiente , Fragmentos de Peptídeos/metabolismo , Doença de Alzheimer/genética , Precursor de Proteína beta-Amiloide/genética , Animais , Modelos Animais de Doenças , Feminino , Hipocampo/patologia , Humanos , Antígeno Ki-67/metabolismo , Lactação/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Proteínas Associadas aos Microtúbulos/metabolismo , Mutação/genética , Neurogênese/genética , Neuropeptídeos/metabolismo , Placa Amiloide/patologia , Gravidez , Presenilina-1/genética , Trissacarídeos/metabolismo
20.
Gerokomos (Madr., Ed. impr.) ; 29(2): 79-82, jun. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-175037

RESUMO

Introducción: La enfermedad de Alzheimer es una demencia que afecta a un número cada vez mayor de personas. Estos pacientes precisan de una atención continua, prestada habitualmente por sus familiares. El cuidador informal es la persona encargada de realizar el cuidado no profesional de los pacientes dependientes, lo que puede conllevar en ellos repercusiones físicas, sociales y psíquicas, susceptibles de intervención profesional. El objetivo es analizar las necesidades más demandadas por familiares de pacientes de Alzheimer, estudiar los recursos sociosanitarios ofertados y concretar las competencias enfermeras en el abordaje del paciente y su familia. Material y métodos: Revisión bibliográfica en Cuiden, Elsevier, Dialnet, SciELO y Google Academic, de aquellos trabajos que analizan las necesidades, recursos sociosanitarios y competencias de enfermería sobre la enfermedad de Alzheimer. En total se analizaron 40 artículos. Resultados: Las necesidades más demandadas por los cuidadores son las de información, formación, ayuda física, atención al duelo y apoyo social. Los recursos sociosanitarios disponibles para facilitar la atención de estos son la atención a domicilio y diurna de no internamiento entre otros. Los cuidadores perciben que no se utilizan todos los recursos sociosanitarios disponibles. Los enfermeros aportan apoyo y cuidado, y destacan sobre todo las intervenciones de tipo psicoeducativo. Conclusión: Las necesidades de los cuidadores abarcan las dimensiones física, psíquica y social. Los recursos sociosanitarios a disposición de los cuidadores se encuentran infrautilizados y las intervenciones enfermeras más valoradas son las estrategias de educación sanitaria. Es preciso seguir investigando para ampliar los conocimientos que permitan ofrecer cuidados de calidad


Introduction: Alzheimer disease is a dementia which affects an increasing number of people. Those patients require continued assistance which is usually given by their relatives. The informal carer is the person in charge of the non-professional care of the dependent patients. This can imply physical, social and psychic repercussions, susceptible to professional intervention. The goal is analysing the most demanding necessities by the relatives of Alzheimer’s patients, studying the offered socio-health resources and concreting the nursing competencies in the approach of the patient and his family. Material and methods: Bibliographic revision in Cuiden, Elsevier, Dialnet, SciELO and Google Academic, of those works which analyse the necessities, sociohealth resources and nursing competences about Alzheimer disease. Overall forty articles were analysed. Results: The most demanding necessities by the cares are related with the information, formation, physical help, grief attention and social support. The available socio-health resources to ease their attention are for instance, the home care and the daytime and non-hospitalized attention. The cares observe that the available socio-health resources are not completely used. The nurses give support and care, especially in the psychoeducational interventions. Conclusion: The necessities of the cares cover physical, psychic and social dimensions. Their available socio-health resources are untapped and the most valued nursing interventions are the health education strategies. It is necessary to carry out more research in order to broaden the knowledge which allows us to provide good quality cares


Assuntos
Humanos , Doença de Alzheimer/enfermagem , Cuidadores/educação , Doença de Alzheimer/psicologia , Serviços de Assistência Domiciliar , Apoio Social
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